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Patient Account Services Research Analyst - 4046 in Brentwood, TN at PathGroup

Date Posted: 6/15/2018

Job Snapshot

Job Description

JOB SUMMARY:

The Patient Account Services Research Analyst, under the direction of the Director of Accounts Receivables, performs the daily activities of analyzing, identifying and solving complex reimbursement issues and trends within the Patient Account Services department.  The Patient Account Services Research Analyst also works closely with the Director of Accounts Receivables to complete special projects as needed.

JOB RESPONSIBILITIES

ESSENTIAL FUNCTIONS:

  • Responsible for the review and follow-up of outstanding accounts and projects, adhering to productivity guidelines as established by the Director of Accounts Receivables.
  • Analyze and review reports to identify reimbursement problems and trends within insurance companies.
  • Compose letters to insurance companies and network representatives to resolve reimbursement problems.
  • Serve as liaison between Patient Account Services and oncology for high sensitivity patients and accounts
  • Research account issues that have escalated beyond Patient Account Service Coordinator.
  • Contact insurance companies to resolve contract issues regarding rates of payment or improper denial patterns.
  • Serves as project leader in the development and implementation of training manuals and materials, and QA programs.
  • Train Patient Account Services personnel in the function of IDX, ETM and PCS, consistent with their level of security access. Prepare copies of training documentation.
  • Audits and reports on quality and productivity standards annually.Provides billing application support to end users, analyzing all modules used in the Patient Account Services department to ensure effectiveness, provide recommendations for improvements, etc.
  • Assist with the implementation and testing of all upgrades to existing applications as well as new applications/modules.
  • Analyze, identify and implement resolution for issues related to Interfaces, Insurance Carrier acceptance files, and claims acknowledgements.
  • Perform all job responsibilities in alignment with the industry’s best security practices and regulatory guidelines to protect the confidentiality, integrity, and availability of protected health information and other sensitive company data.
  • Must be familiar with and abide by the Corporate Compliance Program and all corporate policies, including the Privacy and Security policies.

Job Requirements

NON-ESSENTIAL FUNCTIONS:

  • Work with other departments within PathGroup and subsidiaries.
  • Nothing in the job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.
  • Other duties as assigned.

EDUCATION & LICENSURE:

  • High school diploma or GED is required.

REQUIREMENTS:

  • Three to five years of prior job-related experience is required.
  • Experience with healthcare revenue cycle management solutions is required.
  • Knowledge of system interfaces with Accounts Receivable is required.
  • Knowledge of fee schedules and contracted insurance companies preferred.
  • Experience in pathology or laboratory billing preferred.